INCOMPLETE applications, including those that do not follow the instructions, will NOT be considered.

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1 McCone Conservation District Application Instructions. Thank you for your interest in the District Administrator position. Please read and follow these instructions prior to filling out application. Thank you. 1. Complete this application by typing or printing in ink. 2. If a question does not apply to you, write N/A. 3. The application is reviewed separately from any other materials submitted and will be used to evaluate your qualifications for this position. Therefore, you must answer all questions rather than referring to your resume or other materials you may have submitted. DO NOT write See Attached. 4. We require this application, a resume, and a cover letter to be submitted. Other material such as a transcript, letters of recommendation, or project examples are also accepted but not necessary. 5. You may attach additional sheets if necessary. If so, make reference to the topic you are addressing. 6. Original or digital signatures are accepted. 7. INCOMPLETE applications, including those that do not follow the instructions, will NOT be considered. Submit application, cover letter, and resume to: McCone Conservation District PO Box 276 Circle MT Or to mcconecd@macdnet.org

2 McCone Conservation District Employment Application All potential employees are evaluated without regard to race, color, gender, religion, national origin, age, martial or veteran status, the presence of a non-job related handicap or any other legally protected status. APPLICANT INFORMATION Last Name First M.I. Date Street Apartment/Unit # City State ZIP Date Available Social Security No. Desired Salary Position Applied for Date of Birth Are you a citizen of the United States? YES NO Have you ever been employed by this company? YES NO If so, when? Have you ever been convicted of a felony? YES NO If yes, explain If no, are you authorized to work in the U.S.? Type of Drivers License State Issued License Number YES NO EDUCATION High School College / Other / REFERENCES Please list three references that you are not related to and have known for at least one year. Company ( ) Company ( ) Company ( )

3 PREVIOUS EMPLOYMENT (LIST MOST RECENT EMPLOYMENT FIRST AND IN CHRONOLOGICAL ORDER) Company ( ) Job Starting Salary $ Ending Salary $ Company ( ) Job Starting Salary $ Ending Salary $ Company ( ) Job Starting Salary $ Ending Salary $ MILITARY SERVICE Branch From To Rank at Discharge Type of Discharge If other than honorable, explain For the following questions, please use an additional sheet of paper only if more room is needed. For the purposes of the following questions the term Employment includes work as an Independent Contractor. ARE YOU FAMILIAR WITH THE OPERATION AND MISSION OF CONSERVATION DISTRICTS (CD)? HAVE YOU EVER WORKED AS AN EMPLOYEE OR INDEPENDENT CONTRACTOR FOR A CD? YES NO SO, LIST CD AND DESCRIBE WORK PERFORMED. IF

4 DESCRIBE A SPECIFIC NATURAL RESOURCE PROJECT(S) HERE AND DESCRIBE WHY IT WAS SUCCESSFUL. ALSO LIST ADDITIONAL NATURAL RESOURCE EXPERIENCE HERE. DESCRIBE YOUR EXPERIENCE IN OFFICE ADMINISTRATION. DESCRIBE YOUR EXPERIENCE IN COORDINATING WORKSHOPS OR SEMINARS. DESCRIBE YOUR EXPERIENCE IN SOURCING AND WRITING GRANTS. DESCRIBE YOUR EXPERIENCE WORKING FOR A BOARD OF SUPERVISORS OR SIMILIAR. LIST ANY AGICULTURE EXPERIENCE LIST ANY CONSERVATION OR RESOURCE MANAGEMENT EXPERIENCE LIST COMPUTER, ELECTRONIC, OR MECHANICAL EQUIPMENT THAT YOU ARE QUALIFIED TO OPERATE LIST ANY SKILLS OR HOBBIES THAT MAY BE RELEVANT FOR THIS POSITION

5 LIST ANY CIVIC, VOLUNTEER, OR PROFESSIONAL AFFILIATIONS THAT ARE RELEVANT TO THIS POSITION IN YOUR PREVIOUS EMPLOYMENT EXPERIENCES DESCRIBE YOUR ABILITIES AND LIMITATIONS IN WORKING WITH SUPERVISORY PERSONNEL, CO-WORKERS, OR CONTRACT AGENTS. ON A SCALE OF 1 TO 10 WITH 10 BEING THE HIGHEST AND 1 BEING THE LOWEST: CIRCLE YOUR ABILITY TO WORK INDEPENDENTLY: CIRCLE YOUR ABILITY TO WORK AS PART OF A TEAM: CHECK DAYS AND LIST HOURS YOU ARE AVAILABLE TO WORK I would prefer to work: Full Time ¾ Time Part Time Flex Time Su Mo Tu We Th Fr Sa. Please describe days/hours that you are not available to work: DISCLAIMER AND SIGNATURE Information to the Applicant: As part of our procedure for processing your employment application, your schooling, personal, and professional references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. If you are currently employed and do not want the District to contact your current employer, you must inform the District of this request. Applications will be kept for a period of one year and may be open to the public for view. I understand and agree to a background check and drug testing if hired. I certify that my answers are true and complete to the best of my knowledge. Signature Date Room for additional information, if needed.